When you’re experiencing a mental health concern like depression, it may seem overwhelming, especially if you feel like you’re in crisis. It can be hard to know where to turn for help or what your next steps might be—depression medication? Counseling or therapy?
A great place to start is with your primary care provider. You probably think of us when it’s time for your annual physical or you need treatment for routine illnesses. But many of us have extensive training in dealing with depression, anxiety and other common psychiatric disorders. We’re here to help.
Still, some of my patients—even those I know well and have treated for years—say that, when it came to talking about their mental health, the hardest part was starting the conversation.
My advice is to simply say, “I think I may be depressed.”
Knowing when to get help for depression
It can be difficult to tell the difference between common changes in your mood and chronic depression. Talking to your primary care doctor can help you sort that out.
The main thing to be aware of is how often you are feeling down or depressed. Overall, if you are generally functioning well and are usually happy or positive but feel down or overwhelmed in stressful or traumatic situations, there’s probably no reason to worry. These are normal fluctuations in your mood.
But if feelings of sadness or hopelessness dominate your mood for more than two weeks and interfere with your daily activities, it’s time to seek care.
You can bring up your concerns during your annual wellness exam. But if there are several nagging issues that need to be addressed during that yearly visit, it may be better to make a separate appointment to talk about your mood.
If you’re struggling or are worried that your mood is getting worse, don’t wait until your annual visit. Make an appointment with your primary care doctor as soon as possible so you can start treatment and get back to feeling like your former happy self.
Preparing for the conversation
You can get ready to discuss your feelings with your doctor by thinking through your day-to-day life. Ask yourself questions like:
- Are you doing things that bring you joy and happiness?
- Are you enjoying friends and family?
- Do you feel happiness and joy?
- Do you have an underlying sense of dread that keeps you from seeing the beauty in life?
- Are you where you thought you would be at this stage in your life?
- How do you feel about your life goals for a month from now? Six months from now? A year from now?
Make notes about any changes in your habits, daily routine or situations in which you didn’t react the way you normally would.
Talking about your mood
Once you tell me that you may be depressed, we’ll talk about how you’ve been feeling and how long you’ve felt this way. I may ask you questions like:
- How you’ve been feeling physically
- Whether you’re keeping up with your daily routine
- How well you handle simple disruptions in your routine
- If there have been any changes in your eating habits
- Whether you’re connecting as usual with family, friends, colleagues and others
- How your most important relationships are going
- Whether there have been any changes in your habits
- If you’re questioning your short- or long-term goals
I may also order blood tests to help rule out other causes for your mood change, like an underactive thyroid or vitamin D deficiency.
Finding the right treatment for your depression
If we determine that you may be clinically depressed, we’ll talk over your options. There are many treatments for depression, including regular sessions with a counselor or medication. Simple changes like getting more exercise, improving your sleep or breaking bad habits also can help boost your mood.
Keep in mind that treatment is a process. You may meet with several counselors before you find the right fit. Sometimes the first or even second or third medicine you try doesn’t work, or you may not be able to tolerate the side effects.
Stay in touch with your primary care doctor during the process, and work with them to find the treatment that is best for you.
Don’t be afraid to talk to your doctor
Don’t hesitate to talk to your primary care doctor if you think you may be depressed. Depression can be deadly, but like any other disease, it can be treated. And you don’t have to go it alone.
Even if you don’t think you’re clinically depressed but just overwhelmed by life’s events—the death of a loved one or pet, problems at work or school, or simply your hectic everyday schedule—you should still talk to your doctor. Together you can figure out the best way to get you through this difficult period.
Once you’ve started the conversation, keep talking to your doctor. Depression isn’t a one-and-done conversation. Even if you see a counselor, make sure to stay in touch with your primary care physician so they can monitor your treatment plan and help you stay with it.
Don’t ignore the signs of depression. Help is available, and it’s as close as your primary care doctor’s office. If you or a loved one is struggling, schedule a visit so you can start to move forward together.
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About the author
Anne Marie Eschberger, MD, is a family medicine physician at Baylor Scott & White Clinic – College Station University Drive. She received her medical degree and completed her residency in family medicine at Texas A&M University Health Science Center. She currently resides in College Station with her husband, two daughters and son. Her hobbies include anything outdoors, photography and reading.